Open AccessAnesthetic management for combined mitral valve replacement and aortic valve repair in a patient with osteogenesis imperfecta
Author(s) -
Jiapeng Huang,
Michelle Dinh,
Nicholas Kuchle,
Jing Zhou
Publication year - 2011
Publication title -
annals of cardiac anaesthesia/annals of cardiac anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.42
H-Index - 27
eISSN - 0974-5181
pISSN - 0971-9784
DOI - 10.4103/0971-9784.81566
Subject(s) - medicine , osteogenesis imperfecta , anesthesia , mitral regurgitation , aortic valve , mitral valve , coagulopathy , airway management , cardiology , aortic valve repair , surgery , intubation , aorta , aortic root , pathology
Osteogenesis imperfecta is a rare disorder of connective tissues and presents multiple challenges, including difficult airway, hyperthermia, coagulopathy and respiratory dysfunction, for anesthesiologists, especially during cardiac surgery. We present anesthetic management of a patient with osteogenesis impertecta during double valve surgery. Dexmedetomidine infusion minimized the risks of malignant hyperthermia. Glidescope and in-line stabilization facilitated endotracheal intubation and protected his oral structures and cervical spine. Transesophageal echocardiography (TEE) diagnosed a flail A3 segment and redundant left coronary cusp causing mitral and aortic regurgitation. The mitral valve was replaced and the aortic valve repaired. Coagulopathy was corrected according to comprehensive coagulation analysis. Glidescope, dexmedetomidine, coagulation analysis and TEE could facilitate anesthetic management in these patients.